Provider Demographics
NPI:1912114349
Name:KINGS VIEW
Entity Type:Organization
Organization Name:KINGS VIEW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CANDIE
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-457-2302
Mailing Address - Street 1:1410 F ST STE 101
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93706-1608
Mailing Address - Country:US
Mailing Address - Phone:559-457-2302
Mailing Address - Fax:
Practice Address - Street 1:1410 F ST STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93706-1608
Practice Address - Country:US
Practice Address - Phone:559-475-2302
Practice Address - Fax:559-457-2324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100026AN251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA100026ANOtherSTATE ALCOHOL DRUG CERTIF